Basic Information
Provider Information
NPI: 1801565221
EntityType: 2
ReplacementNPI:  
OrganizationName: WH FL DENTAL PLLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 702 SW 8TH ST # MS 0445
Address2:  
City: BENTONVILLE
State: AR
PostalCode: 727160445
CountryCode: US
TelephoneNumber: 4792041258
FaxNumber: 4792774331
Practice Location
Address1: 11242 E COLONIAL DR
Address2:  
City: ORLANDO
State: FL
PostalCode: 32817
CountryCode: US
TelephoneNumber: 4072818941
FaxNumber: 4072824152
Other Information
ProviderEnumerationDate: 09/09/2021
LastUpdateDate: 09/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: PARUAS
AuthorizedOfficialFirstName: ADRIAN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER WH FL DENTAL PLLC
AuthorizedOfficialTelephone: 4792041258
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X  Y193400000X SINGLE SPECIALTY GROUPDental ProvidersDentist 

No ID Information.


Home